HomeMy WebLinkAboutbuilding permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,!wort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PRO OSED IMPROVEMENT LOCATION:
Address: CD
Legal Description:
Property Tax ID#: ()_3 _ f .— Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
[PE
__TAILED DESCRIPTION OF WORK:
i
-ed— . G{0>e_- CdVq se-r u%n
CONSTRUCTION INFORMATION:
Additional worT to b Ef
r orme un er t is permit—c hecka apply'
OHVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
0Electric El Plumbing ❑Sprinklers EJ Generator O Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ UtilitiestSewer OSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Name:_ e< �•.3 I
Address: 3 (D (' Company: b&
City: ►o-Cc State: Address:.
Zi Code• r '
Zip Code: oZ Fax• City: I—`fit•• rcf State:��
Phone No, 7 Zip Code q 9 Fax:-_a L f - )) d
E-Mail: Phone No. L — S—
Fill in fee simple Title Holder on next page{if different E-Mail: C, Co e7�'_1
from the Owner listed above) State or County License:—C 1 31a
If valu0i of construction is$2500 or more,a RECORDED Notice of Commencement is required.